Skip to main content

Main menu

  • Home
  • Current Issue
  • Archive
  • Info for
    • Authors
    • Subscribers
    • Advertisers
    • Editorial Board
  • Other Publications
    • In Vivo
    • Cancer Genomics & Proteomics
    • Cancer Diagnosis & Prognosis
  • More
    • IIAR
    • Conferences
    • 2008 Nobel Laureates
  • About Us
    • General Policy
    • Contact
  • Other Publications
    • Anticancer Research
    • In Vivo
    • Cancer Genomics & Proteomics

User menu

  • Register
  • Subscribe
  • My alerts
  • Log in
  • My Cart

Search

  • Advanced search
Anticancer Research
  • Other Publications
    • Anticancer Research
    • In Vivo
    • Cancer Genomics & Proteomics
  • Register
  • Subscribe
  • My alerts
  • Log in
  • My Cart
Anticancer Research

Advanced Search

  • Home
  • Current Issue
  • Archive
  • Info for
    • Authors
    • Subscribers
    • Advertisers
    • Editorial Board
  • Other Publications
    • In Vivo
    • Cancer Genomics & Proteomics
    • Cancer Diagnosis & Prognosis
  • More
    • IIAR
    • Conferences
    • 2008 Nobel Laureates
  • About Us
    • General Policy
    • Contact
  • Visit us on Facebook
  • Follow us on Linkedin
Research ArticleClinical Studies

Neuroendocrine Tumor of the Hilar Bile Duct

NAOKI UMEZAKI, DAISUKE HASHIMOTO, YO-ICHI YAMASHITA, SHIGEKI NAKAGAWA, YOUSUKE NAKAO, RUMI ITOYAMA, TOSHIHIKO YUSA, TAKANOBU YAMAO, HIROHISA OKABE, KATSUNORI IMAI, HIROMITSU HAYASHI, AKIRA CHIKAMOTO and HIDEO BABA
Anticancer Research February 2019, 39 (2) 903-907; DOI: https://doi.org/10.21873/anticanres.13192
NAOKI UMEZAKI
Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
DAISUKE HASHIMOTO
Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
YO-ICHI YAMASHITA
Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
SHIGEKI NAKAGAWA
Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
YOUSUKE NAKAO
Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
RUMI ITOYAMA
Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
TOSHIHIKO YUSA
Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
TAKANOBU YAMAO
Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
HIROHISA OKABE
Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
KATSUNORI IMAI
Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
HIROMITSU HAYASHI
Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
AKIRA CHIKAMOTO
Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
HIDEO BABA
Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: hdobaba@kumamoto-u.ac.jp
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

Abstract

Neuroendocrine tumors usually develop in the gastrointestinal tract, pancreas, and lung. Therefore, a neuroendocrine tumor of the bile duct is quite rare. We present a 59-year-old-male patient whose preoperative diagnosis was hilar cholangiocarcinoma. One month after embolization of the left branch and anterior branch of the portal vein, he underwent left hepatic trisegmentectomy and extrahepatic bile duct resection. Pathological examination revealed the neuroendocrine tumor in the submucosal layer of the hilar bile duct. Because there was no neuroendocrine tumor in other organs, the tumor was considered a primary neuroendocrine tumor of the hilar bile duct, rather than a liver metastasis from other organs. We also present a review of the English literature regarding neuroendocrine tumors of the bile duct.

  • Neuroendocrine tumor
  • bile duct tumor
  • operation

Neoplasms of the extrahepatic bile duct are uncommon gastrointestinal tumors (1-3). The most common neoplasm arising from the biliary tree is adenocarcinoma, accounting for up to 80% of all bile duct tumors (1, 3-5).

Neuroendocrine tumors (NET) are considered relatively rare tumors (4). NET are usually developed in the gastrointestinal tract, pancreas, and lung (4, 5). NET of the extrahepatic bile duct is exceedingly rare, and accounts for 0.1% to 0.2% of NETs of the gastrointestinal tract (3).

As there was a small number of similar cases in the English literature, we would like to present a case of NET of the hilar bile duct. We also present a review of the English literature regarding similar cases to summarize the diagnosis and treatment of patients with this tumor, which is difficult to diagnose pre-operatively and distinguish from cholangiocarcinoma.

Case Report

A 59-year-old-man was referred to us because of elevated γ-GTP (265 U/l) and the ultrasonographic dilatation of intrahepatic bile ducts (IHBD), which were pointed out in the annual comprehensive medical checkup.

In further examination, a contrast-enhanced computed tomography (CT) scan revealed a 27 mm tumor with ring enhancement at the hepatic portal region (Figure 1A), and dilatation of IHBD. Magnetic resonance cholangiopancreatography indicated a defect in the visualized bile duct consistent with the tumor and dilatation of the intrahepatic bile duct (Figure 1B). The patient was preoperatively diagnosed with a hilar cholangiocarcinoma. Because he did not show jaundice and his total bilirubin was not elevated (1.1 mg/dl), endoscopic retrograde cholangiopancreatography (ERCP) was not planned. No evidence of distant metastasis was identified. Tumor markers were not elevated (carcinoembryonic antigen 1.7 mg/ml, carbohydrate antigen 19-9 0.6 U/ml).

Because the tumor involved the left hepatic duct and the branch of the bile duct of the anterior segment, we planned a left hepatic trisegmentectomy and extrahepatic bile duct resection. CT-volumetry revealed that the expected volume of the posterior segment was 38.8% (Figure 2A and B). To reduce the loss of liver function by the hepatic resection, embolization of the left branch and anterior branch of the portal vein was performed before surgery. One month after, the expected volume of the posterior segment was increased to 51.2%. Finally, the operation was performed as planned. Intraoperative frozen pathology showed no malignant tumor at the proximal cut end of the common bile duct, and at the distal cut end of the posterior branch. Hepaticojejunostomy with Roux-en-Y reconstruction was performed.

Macroscopically, the tumor appeared as a submucosal tan nodule measuring 2.5×2.0 cm, arising at the common hepatic duct bifurcation and extending into the left hepatic duct (Figure 3A and B). The tumor extended through the bile wall. Microscopically, the tumor was composed of sheets of uniform cells with granular cytoplasm and central and round nuclei with coarse and clustered chromatin (Figure 4A). Surgical margins were negative. No lymph node metastasis was identified.

View this table:
  • View inline
  • View popup
  • Download powerpoint
Table I.

Literature review of NET generated from common hepatic duct published from 1986 to 2017, excluding our case.

In the evaluation of pathology, the Ki-67 labeling index was 1-2%. Immunohistochemistry was positive for CD56, chromogranin A, synaptophysin, arginase-1 and HepPar-1 (Figure 4B-D). Finally, the pathological diagnosis was NET of the hilar bile duct which is G1 in World Health Organization classification. The tumor did not invade the liver parenchyma. In addition, there were no other NETs in the gastrointestinal tract or pancreas. So, the NET of this case was diagnosed as primary, and not as a hepatic metastasis from another primary site.

The patient is alive without metastasis or recurrence 11 months after the operation.

Discussion and Literature Review

NET of the bile duct is quite rare (1-3, 6). In the present case, there was no NET in the other organs which might have been the primary site of the disease and the tumor was considered a primary neuroendocrine tumor of the hilar bile duct, rather than a liver or lymph node metastasis from the other organs.

To indicate clinical features and establish a treatment strategy, we reviewed the English literature, in which 25 cases excluding our case were reported regarding a NET generated from the common hepatic duct (7-28) (Table I). The median age was 37 years (range=6-71 years), and 8 (32%) cases were male and 17 (68%) were female. The most common symptom was jaundice (15 cases, 60%). Median tumor size was 27 mm (range=6-55 mm). The tumor was located at the common hepatic duct in 13 (52%), followed by common hepatic duct bifurcation in 8 (32%). There was no metastasis in 18 cases (72%), whereas lymph node metastasis was observed in 4 cases (16%) (13, 14, 19, 27) and liver metastasis in 3 cases (12%) (11, 23, 25).

Figure 1.
  • Download figure
  • Open in new tab
  • Download powerpoint
Figure 1.

Preoperative image evaluation. Abdominal enhanced CT showed a 27 mm tumor (arrowheads) at the hepatic portal region (A). Magnetic resonance cholangiopancreatography showed a defect in the bile duct and dilatation of the intrahepatic bile duct (B).

Figure 2.
  • Download figure
  • Open in new tab
  • Download powerpoint
Figure 2.

The changes in the volume of the right hepatic lobe after portal vein embolization. Before portal vein embolization (A). After portal vein embolization (B).

The most common operative procedure was extrahepatic bile duct resection in 18 (72%) patients, followed by choledochotomy and tumor resection in 2 (8%) patients. For the patients with tumor of the hilar bile duct, hepatectomy was performed in 2 (8%) cases (12, 26). A patient with unresectable tumor received liver transplantation (18). Radiofrequency ablation for liver metastasis was performed in one (4%) case (23).

Figure 3.
  • Download figure
  • Open in new tab
  • Download powerpoint
Figure 3.

The resected hepatic specimen. The resected tumor appeared as a submucosal tan nodule at the common hepatic duct bifurcation and extending into the left hepatic duct (A). The tumor appeared as a submucosal tan nodule measuring 2.5×2.0 cm (B).

Origin of histological diagnosis was derived from the resected specimen in 22 (88%) patients, from a biopsy during ERCP in one (4%) (25) and from a biopsy during cholecystectomy in another (4%) patient (26). Immunohistochemical analysis showed that chromogranin A was expressed in 21 (84%) patients, synaptophysin in 12 (48%) patients and neuron specific enolase in 9 (36%) patients.

In a median observation period of 24 months (range=4-132 months), only one (4%) disease-specific death was reported (11).

In summary, preoperative diagnosis of NET generated from common hepatic duct is difficult. However, appropriate operation such as extrahepatic bile duct resection, and, if needed, combined hepatectomy contribute to better prognosis. Because of the efficacy of molecular targeted therapies such as everolimus and sunitinib for advanced gastroenteropancreatic NETs has been recently reported (29, 30), multimodality therapy for patients with metastasized NET of common hepatic duct should be considered in the future.

Figure 4.
  • Download figure
  • Open in new tab
  • Download powerpoint
Figure 4.

Pathological diagnosis. Hematoxylin and eosin staining of tissue and cell sections. The tumor was composed of sheets of uniform cells with granular cytoplasm, central, round nuclei, and coarse, clustered chromatin (A). Tissue and cell sections were immunohistochemically stained against CD56 (B), Synaptophysin (C), Chromogranin A (D).

Footnotes

  • Conflicts of Interest

    Naoki Umezaki and the other co-Authors have no conflict of interest to declare regarding this study.

  • Received December 6, 2018.
  • Revision received December 11, 2018.
  • Accepted December 17, 2018.
  • Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved

References

  1. ↵
    1. Chamberlain R,
    2. Blumgart L
    : Carcinoid tumors of the extrahepatic bile duct. A rare cause of malignant biliary obstruction. Cancer 86: 1959-1965, 1999.
    OpenUrlPubMed
    1. Raspanti C,
    2. Falco N,
    3. Silvestri V,
    4. Rotolo G,
    5. Bonventre S,
    6. Gulotta G
    : Neuroendocrine tumor of the common bile duct: case report. G Chir 37: 275-280, 2016.
    OpenUrl
  2. ↵
    1. Felekouras E,
    2. Petrou A,
    3. Bramis K,
    4. Prassas E,
    5. Papaconstantinou I,
    6. Dimitriou N,
    7. Pazaiti A,
    8. Tsigris C,
    9. Giannopoulos A
    : Malignant carcinoid tumor of the cystic duct: a rare cause of bile duct obstruction. Hepatobiliary Pancreat Dis Int 8: 640-646, 2009.
    OpenUrlPubMed
  3. ↵
    1. Yao J,
    2. Hassan M,
    3. Phan A,
    4. Dagohoy C,
    5. Leary C,
    6. Mares J,
    7. Abdalla E,
    8. Fleming J,
    9. Vauthey J,
    10. Rashid A,
    11. Evans DB
    : One hundred years after “carcinoid”: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol 26: 306-372, 2008.
    OpenUrl
  4. ↵
    1. Zwan J,
    2. Trama A,
    3. Otter R,
    4. Larranaga N,
    5. Tavilla A,
    6. Gragera R,
    7. Tos A,
    8. Baudin E,
    9. Poston G,
    10. Links T,
    11. RARECARE WG
    : Rare neuroendocrine tumours: results of the surveillance of rare cancers in Europe project. Eur J Cancer 49: 256-578, 2013.
    OpenUrl
  5. ↵
    1. Michalopoulos N,
    2. Papavramidis T,
    3. Karayannopoulou G,
    4. Pliakos I,
    5. Papavramidis S,
    6. Kanellos I
    : Neuroendocrine tumors of extrahepatic biliary tract. Pathol Oncol Res 20: 765-775, 2014.
    OpenUrl
  6. ↵
    1. Jutte D,
    2. Bell R,
    3. Penn I,
    4. Powers J,
    5. Kolinjivadi J
    : Carcinoid tumor of the biliary system. Case report and literature review. Dig Dis Sci 32: 763-769, 1986.
    OpenUrl
    1. Fujita N,
    2. Mochizuki F,
    3. Lee S,
    4. Satoh K,
    5. Kobayashi G,
    6. Yano A,
    7. Shimoda T
    : Carcinoid tumour of the bile duct: case report. Gastrointest Radiol 14: 151-154, 1989.
    OpenUrlPubMed
    1. van der Wal AC1,
    2. Van Leeuwen DJ,
    3. Walford N
    : Small cell neuroendocrine (oat cell) tumour of the common bile duct. Histopathology 16: 398-400, 1990.
    OpenUrlPubMed
    1. Brown WM 3rd.,
    2. Henderson JM,
    3. Kennedy JC
    : Carcinoid tumour of the bile duct. A case report and literature review. Am Surg 56: 343-346, 1990.
    OpenUrlPubMed
  7. ↵
    1. Rodriguez L,
    2. Manivel J,
    3. Sanchez N,
    4. Jessurun J
    : Carcinoid tumor of the common bile duct: evidence for its origin in metaplastic endocrine cells. Am J Gastroenterol 86: 1073-1076, 1991.
    OpenUrlPubMed
  8. ↵
    1. Gembala R,
    2. Friedman A,
    3. Friedman A,
    4. Radecki P,
    5. Ball D,
    6. Hartman G,
    7. Rabin L,
    8. Caroline DF
    : Carcinoid of the intrahepatic ducts. Abdom Imaging 18: 242-244, 1993.
    OpenUrlPubMed
  9. ↵
    1. Bembenek A,
    2. Lotterer E,
    3. Machens A,
    4. Cario H,
    5. Krause U,
    6. Holzhausen H
    : Neuroendocrine tumor of the common hepatic duct: a rare case of extrahepatic jaundice in adolescence. Surgery 123: 712, 1998.
    OpenUrlPubMed
  10. ↵
    1. Perakath B,
    2. Chandran B,
    3. Srivastava V,
    4. Nair A,
    5. Sitaram V
    : Carcinoid tumor of common hepatic duct. Indian J Gastroenterol 18: 127, 1999.
    OpenUrlPubMed
    1. Chamberlain R,
    2. Blumgart L
    : Carcinoid tumors of the extrahepatic bile duct. A rare cause malignant biliary obstruction. Cancer 86: 1956-1965, 1998.
    OpenUrl
    1. Chan C,
    2. Franco H,
    3. Bell W,
    4. Lazenby A,
    5. Vickers S
    : Carcinoid tumor of the hepatic duct presenting as a Klatskin tumor in an adolescent and review of world literature. Hepatogastroenterology 47: 519-521, 2000.
    OpenUrlPubMed
    1. Maitra A,
    2. Krueger J,
    3. Tascilar M,
    4. Offerhaus G,
    5. Angeles A,
    6. Klimstra D,
    7. Hruban RH,
    8. Albores-Saavedra J
    : Carcinoid tumors of the extrahepatic bile ducts: a study of seven cases. Am J SurgPathol 24: 1501-1510, 2000.
    OpenUrl
  11. ↵
    1. Turrion V,
    2. Salas C,
    3. Alvira L,
    4. Jimenez M,
    5. Lucena J,
    6. Ardaiz J
    : Carcinoid tumour of the common bile duct: an exceptional indication for liver transplantation. Transplant Proc 34: 264, 2002.
    OpenUrlPubMed
  12. ↵
    1. Menezes A,
    2. Diver A,
    3. Cance D,
    4. Diamond T
    : Carcinoid tumour of the extrahepatic bile duct–report of a case and literature review. Ulster Med J 73: 59-62, 2004.
    OpenUrlPubMed
    1. Ligato S,
    2. Furmaga W,
    3. Cartun R,
    4. Hull D,
    5. Tsongalis G
    : Primary carcinoid tumor of the common hepatic duct: a rare case with immunohistochemical and molecular findings. Oncol Rep 13: 543-546, 2005.
    OpenUrlPubMed
    1. Hubert C,
    2. Sempoux C,
    3. Berquin A,
    4. Deprez F,
    5. Jamar F,
    6. Giqot J
    : Bile duct carcinoids tumors: an uncommon disease but with a good prognosis? Hepatogastroenterology 52: 1042-1047, 2005.
    OpenUrlPubMed
    1. Gusani N,
    2. Marsh J,
    3. Nalesnik M,
    4. Tublin M,
    5. Gamblin T
    : Carcinoid of the extra-hepatic bile duct: a case report with long-term follow up and review of literature. The Am Surgeon 74: 87-91, 2008.
    OpenUrl
  13. ↵
    1. Price T,
    2. Thompson G,
    3. Lewis J,
    4. Lioyd R,
    5. Young W
    : Zollinger-Ellisonsyndrome due toprimary gastrinoma of theextrahepatic biliary tree: three case reports and review of the literature. Endocr Pract 15: 737-739, 2009.
    OpenUrlPubMed
    1. Tonnhofer U,
    2. Balassy C,
    3. Reck C,
    4. Koller A,
    5. Horcher E
    : Neuroendocrine tumor of the common hepatic duct, mimicking a choledochal cyst in a 6-year-old child. J Pediart Surg 44: 22-25, 2009.
    OpenUrl
  14. ↵
    1. Malecki E,
    2. Acosta R,
    3. Twaddell W,
    4. Heller T,
    5. Manning M,
    6. Darwin P
    : Endoscopic diagnosis of a biliary neuroendocrine tumor. Gastrointest Endoscopy 70: 1275-1276, 2009.
    OpenUrlPubMed
  15. ↵
    1. Squillaci S,
    2. Marchione R,
    3. Piccolomini M,
    4. Colombo F,
    5. Bucci F,
    6. Bruno M,
    7. Bisceglia M
    : Well-differentiated neuroendocrine carcinoma (malignant carcinoid) of the extrahepatic biliary tract: report of two cases and literature review. APMIS 118: 543-556, 2010.
    OpenUrlPubMed
  16. ↵
    1. Bhalla P,
    2. Powle V,
    3. Shah R,
    4. Jagannath P
    : Neuroendocrine tumor of common hepatic duct. Indian J Gastroenterol 31: 144-146, 2012.
    OpenUrlPubMed
  17. ↵
    1. Raspanti C,
    2. Falco N,
    3. Silvestri V,
    4. Rotolo G,
    5. Bonventre S,
    6. Gulotta G
    : Neuroendocrine tumor of the common bile duct: case report. G Chir 37: 275-280, 2016.
    OpenUrl
  18. ↵
    1. Yao J,
    2. Pavel M,
    3. Bohas C,
    4. Cutsem E,
    5. Voi M,
    6. Brandt U,
    7. He W,
    8. Chen D,
    9. Capdevila J,
    10. de Vries EGE,
    11. Tomassetti P,
    12. Hobday T,
    13. Pommier R,
    14. Öberg K
    : Everolimus for the treatment of advanced pancreatic neuroendocrine tumors: overall survival and circulating biomarkers from the randomized, phase III RADIANT-3 study. J Clin Oncol 34: 3906-3913, 2016.
    OpenUrl
  19. ↵
    1. Raymond E,
    2. Dahan L,
    3. Raoul J,
    4. Bang Y,
    5. Borbath I,
    6. Lombard-Bohas C,
    7. Valle J,
    8. Metrakos P,
    9. Smith D,
    10. Vinik A,
    11. Chen JS,
    12. Hörsch D,
    13. Hammel P,
    14. Wiedenmann B,
    15. Van Cutsem E,
    16. Patyna S,
    17. Lu DR,
    18. Blanckmeister C,
    19. Chao R,
    20. Ruszniewski P
    : Sunitinib malate for the treatment of pancreatic neuroendocrine tumors. N Engl J Med 364: 501-513, 2011.
    OpenUrlCrossRefPubMed
PreviousNext
Back to top

In this issue

Anticancer Research: 39 (2)
Anticancer Research
Vol. 39, Issue 2
February 2019
  • Table of Contents
  • Table of Contents (PDF)
  • Index by author
  • Back Matter (PDF)
  • Ed Board (PDF)
  • Front Matter (PDF)
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on Anticancer Research.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Neuroendocrine Tumor of the Hilar Bile Duct
(Your Name) has sent you a message from Anticancer Research
(Your Name) thought you would like to see the Anticancer Research web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
6 + 13 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Neuroendocrine Tumor of the Hilar Bile Duct
NAOKI UMEZAKI, DAISUKE HASHIMOTO, YO-ICHI YAMASHITA, SHIGEKI NAKAGAWA, YOUSUKE NAKAO, RUMI ITOYAMA, TOSHIHIKO YUSA, TAKANOBU YAMAO, HIROHISA OKABE, KATSUNORI IMAI, HIROMITSU HAYASHI, AKIRA CHIKAMOTO, HIDEO BABA
Anticancer Research Feb 2019, 39 (2) 903-907; DOI: 10.21873/anticanres.13192

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Reprints and Permissions
Share
Neuroendocrine Tumor of the Hilar Bile Duct
NAOKI UMEZAKI, DAISUKE HASHIMOTO, YO-ICHI YAMASHITA, SHIGEKI NAKAGAWA, YOUSUKE NAKAO, RUMI ITOYAMA, TOSHIHIKO YUSA, TAKANOBU YAMAO, HIROHISA OKABE, KATSUNORI IMAI, HIROMITSU HAYASHI, AKIRA CHIKAMOTO, HIDEO BABA
Anticancer Research Feb 2019, 39 (2) 903-907; DOI: 10.21873/anticanres.13192
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • Case Report
    • Discussion and Literature Review
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Pelvic Recurrence After Curative Resection for Rectal Adenocarcinoma: Impact of Surgery on Survival
  • Glasgow Prognostic Score Predicts Survival and Recurrence Pattern in Patients With Hepatocellular Carcinoma After Hepatectomy
  • Small Bowel Lipomatosis: An Unusual Radiological Finding in Patients With Renal Cell Cancer on Pazopanib
Show more Clinical Studies

Similar Articles

Keywords

  • neuroendocrine tumor
  • bile duct tumor
  • operation
Anticancer Research

© 2023 Anticancer Research

Powered by HighWire